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KMID : 0385920230340010063
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Journal of the Korean Society of Emergency Medicine
2023 Volume.34 No. 1 p.63 ~ p.69
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Optimal timing for performing percutaneous transhepatic gallbladder drainage to severe acute cholecystitis patients who visit the emergency department
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Choi Jun-Young
Ryu Hyun-Sik
Park Seong-Soo
Lee Jae-Kwang
Choi Hyun-Soo
Hwang Seung-Yeon
Jang Ji-Yeon
Lee Se-Jong
Lee Hye-Ji
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Abstract
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Objective: Severe acute cholecystitis is an infectious disease that requires immediate gallbladder drainage. Although percutaneous transhepatic gallbladder drainage (PTGBD) is the most common method of gallbladder drainage, the optimal timing remains unclear.
Methods: This study is a retrospective analysis of patients diagnosed with severe acute cholecystitis who underwent PTGBD between July 2018 to June 2021. This study investigated the effect of time from emergency department arrival to PTGBD (tPTGBD) on patient prognosis.
Results: Totally, 48 patients were included in this study. Based on the cutoff value calculated using the Youden index, the group with tPTGBD of <5.93 hours had a shorter hospital stay (10 vs. 13.5 days, P=0.021), lower portion of progression (27:5 [15.6%] vs. 7:9 [56.3%], P=0.004), even they had a higher initial SOFA score (6 vs. 4.6, P=0.049). However, no statistical difference was obtained for the length of ICU stay between both groups (1 vs. 2, P=0.617).
Conclusion: Executing PTGBD to severe acute cholecystitis patients within 5.93 hours after presenting at the emergency department is associated with reduced progression and hospital stay.
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KEYWORD
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Acute cholecystitis, Organ dysfunction scores, Cholecystostomy
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